Mindfulness based childbirth and parenting program : supporting a good beginning

Introduction: Considering the scale of population mental health problems and the risk of transmission of mental health vulnerability within families, it is urgent to find and implement efficient preventive interventions starting early in life. In line with this rationale, this thesis evaluates a Swedish version of the Mindfulness Based Childbirth and Parenting Program (MBCP). Objectives: This thesis aims to: 1) test the short- and long-term efficacy of MBCP in reducing pregnant women’s perceived stress and preventing perinatal depression; 2) evaluate effects on infant social-emotional development; and 3) explore MBCP-participants’ experiences of the program. Methods: Pregnant women (n = 193) at risk for perinatal depression were randomized to MBCP or an active control condition (a Lamaze childbirth class). Self-reported data on perceived stress, depressive symptoms, positive states of mind, and levels of mindfulness were provided by the women at baseline, postintervention and at three, nine, and twelve months postpartum. At three months postpartum, the mothers also reported estimates of their infants’ social-emotional development. At the same timepoint, 16 in-depth interviews were carried out with mothers and fathers who had participated in the MBCP program. Results: From pre- to postintervention, the women who were randomized to MBCP reported significantly larger reductions in perceived stress and depressive symptoms and larger increases of positive states of mind and level of mindfulness compared to the women randomized to the control condition. The treatment effects of MBCP on perceived stress, depressive symptoms, and positive states of mind seemed to be mediated by increased levels of mindfulness. These initial effects were not sustained at longer-term follow-up assessments during the first year postpartum. However, the mothers in the MBCP-arm, who continued to practice mindfulness during the follow-up period retained the interventioneffects to a higher degree than the mothers in the MBCP-arm who did not continue to practice. At three months, mothers in the MBCP-arm perceived that they could understand their infants’ cues to a higher degree and that their infant had a better capacity to selfregulate, compared with mothers in the Lamaze-arm. Mothers and fathers who were interviewed, experienced that participating in the MBCP program increased their capacity to cope with stress, anxiety, pain, and distress. A number of parents also experienced becoming more self-compassionate, insightful, better at communicating and having a stronger sense of being present in nature and with their infant. Conclusion: The crucial developmental phase humans go through, in the womb, in infancy, and during pregnancy and early parenting – men and women alike, gives us a window of opportunity to support a positive development in ways that can have far-reaching effects. MBCP is a promising intervention for seizing that opportunity. The intervention promotes well-being and builds resilience to deal with challenges in pregnancy, childbirth, infant-care, co-parenting and life in general